The current race to replace Margaret Chan, outgoing Director-General of WHO, has been a different kind of contest. The unprecedented level of transparency and accountability in the election campaign is to be welcomed—voting by member states and not only by the agency’s executive board, publication and scrutiny of candidate manifestos, and public debates. But will the final decision making, to take place next week at the World Health Assembly in Geneva, also be different? The vote remains a secret ballot, member states can pledge their support to one candidate but vote for another, and, in the end, the choice of WHO’s next leader, still the world’s top international health post, will be as political as ever.